The objective of this study was to know the response of supplementation of Phaleria macrocarpa (PM) to adriamycin-cyclophosphamide (AC) in the treatment of C3H mice with breast cancer. Twenty-four C3H mice, who were successfully inoculated with breast cancer cells, were randomly allocated into 4 groups: without treatment, treated with AC, treated with AC + PM 0.07 mg/d, and treated with AC + PM 0.14 mg/d. The tumor size was measured using millimeter calipers before and 12 weeks after treatment. The tumor, liver, and kidneys were removed and prepared for pathologic examination using imunohistochemistry staining, and the apoptotic index was counted using the terminal deoxynucleotidyl transferase dUTP nick end labeling method. AC reduce the tumor growth significantly (P < 0.001), whereas supplementation of PM, which significantly reduced the tumor growth compared with AC only, was at the 0.14 mg/d dose (P = 0.007). AC increase the apoptotic index significantly (P < 0.001), and supplementation with PM showed that the higher dose increased the apoptotic index. The correlation between the apoptotic index and the diameter of tumor was significantly negative (r = -0.884; P = 0.020). The apoptotic index of the liver and kidney increased significantly in the AC group (P < 0.001 and P = 0.002, respectively); supplementation with PM decreased significantly the high apoptotic index caused by AC. We conclude that PM supplementation has a synergic effect to AC treatment in reducing the tumor growth, by increasing apoptosis, and protects the liver and kidney from damage caused by AC.

Background The 1st, 2nd and small 3rd degree hemorrhoids are non-operatively treated by using anti-inflammatory and plebotonic medicines, high fiber diet and changing lifestyle. Graptophyllum pictum (L.) Griff (GP) is potential to be a hemorrhoid medicine (anti-inflammatory and plebotonic medicine) since its anti-inflammatory effect may be related to antioxidant property. ObjectiveTo elaborate the anti-inflammatory and anti-oxidant effect of GP on experimental hemorrhoid in male Wistar rats. MethodsA Randomized Controlled Trial Post-test only design in hemorrhoid-like rats using croton oil induced into the anus for 30 seconds each day for 3 consecutive days. 14 Wistar rats were randomly allocated into 2 groups. Group 1 got normal saline solution, while group 2 treated with GPE 100mg/Kg bw for 5 consecutive days. On the 9th experimental day, the blood was drawn for Elisa examination of COX-2 and SOD levels. As COX-2 and SOD normally distributed, pool t-test and product moment correlation was used for statistical analysis. Results All of Wistar rats were still alive. COX-2 levels (ng/ml) in the GPE group was 266.28±158.47, was significantly lower compared to control (595.21±68.92) (p=0.000). Serum SOD levels (ng/ml) in the GPE was 77.00±11.0, and was significantly higher than the control 28.00±4.00 (p=0.02). Correlation between COX-2 and SOD serum level was significantly strong negative correlation (p=0,000 and r=-0.842) Conclusions GPE at a dose of 100 mg/kg bw has antioxidant and anti-inflammatory effects on artificial hemorrhoids through decreased COX-2 levels, and elevated SOD levels. There is a strong negative correlation between SOD and COX-2 serum level.  KeywordsGraptophyllum pictum, hemorrhoids, Croton oil, COX-2, SOD.

BACKGROUND: Cholestasis caused by obstruction of the common bile duct and may developed gut-derived sepsis due to reactive oxygen species (ROS) accumulation. Ursodeoxycholic acid (UDCA) and glutathione are widely known for their antioxidant properties, that might be beneficial against ROS. However, the effects of UDCA-glutathione combination against ROS have not been well elucidated in previous studies. Thus, this study was conducted to evaluate tumor necrosis factor (TNF)-α level and height of terminal ileal mucosal villus after UDCA-glutathione administration in cholestasis rat model.METHODS: Twenty-eight male Sprague Dawley rats were randomly grouped into four treatment groups, each group consisted of seven rats that had previously undergone bile duct ligation. Three groups received treatment of UDCA-glutathione combination on stratified dose, while the other one only received UDCA. Each treatment was given for 21 days. Ileal samples were collected from the rats and stained with mouse anti TNF-a antibody and hematoxylin-eosin (HE). Immunohistochemistry and histopathological examination were done using microscope and then calculated with ImageJ.RESULTS: The combination of UDCA and glutathione treatment decreased the TNF-α expression (p<0.05) compared to UDCA only group, particularly in group that received 20 mg UDCA and 15 mg glutathione supplementation (p<0.05) and group that received 30 mg UDCA and 20 mg glutathione supplementation (p<0.05). The height of the mucosa villous was higher in the UDCA-glutathione combination groups for all the three dosage variations given (p<0.05) compared to UDCA only group.CONCLUSION: UDCA-glutathione combination downregulates TNF-α expression and improves ileum mucosal villus height in cholestasis.KEYWORDS: cholestasis, glutathione, intestinal villus height, TNF-α, UDCA

Hemorrhoids are a common anorectal disease and are often found in clinical practice. Patients mostly come with a complaint of anal bleeding or prolapsing mass. Grade III and IV prolapsing hemorrhoids are distinguished from grade II by the fact that grade II prolapse only during defecation and returns simultaneously after defecation and usually does not cause complaint. Prolapsing hemorrhoids should be differentiated from prolapsing rectal polyps, small rectal prolapse, anorectal tumors, hypertrophy of the anal papilla, and condylomas. Nowadays, the management of prolapsing hemorrhoids varies. Medical therapy is rarely used alone, it is used to improve the effect of surgical therapy. The surgical gold standard for prolapsing hemorrhoids is excision surgery (hemorrhoidectomy) with or without suturing. However, since it comes with pain complaints, non-excision surgery is now offered. Non-excision surgery is divided into two types—stapled hemorrhoidopexy and hemorrhoidal artery ligation and rectoanal repair. Each method of surgery has its own advantages and disadvantages. This chapter review discusses the anatomy, pathophysiology, diagnosis, and management of prolapsing hemorrhoids.

The author would like to study the effects of ethanol Graptophyllum pictum (L.) Griff extract (EGPE) as anti-inflammation on wistar with experimental hemorrhoids. RCT post-test only design were done on 28 wistar, that were allocated into four groups. The 2nd , 3rd and 4th group were induced with 6% croton oil into anus for three days, the 1st group was not induced. On the 4th day, 1st and 2nd group were given physiologic saline, 3rd and 4th group was given EGPE 100 mg and 300 mg/ kg bw respectively. At the 9th day, before termination, blood was aspirated from retro-ocular region for examination of serum IL-6, COX-2 and TNF-alpha using ELISA method, and SGOT, SGPT, urea and creatinine level. Anus was removed and prepared for microscopic examination to count the leucocyte under 400 HPF. Induction of 6% croton oil was significantly increased TNF-alpha, IL-6, COX-2 and leucocyte count. Treatment with EGPE dose 100 mg and 300 mg/ kg bw significantly reduce TNF-alpha, IL-6, COX-2 and leucocyte count, dose 100 mg was even better than 300 mg except for leucocyte count. SGOT, SGPT, blood urea and creatinine were not significantly different among groups. In conclusion, the EGPE 100 mg and 300 mg have anti-inflammatory effects in hemorrhoids wistar, which can suppress IL-6, COX-2, TNF-alpha, and total leucocytes. The EGPE dose 100 mg is better than dose 300 mg. EGPE save for kidney and liver.